Comparison of hospital-based versus home-based exercise training in patients with heart failure: effects on functional capacity, quality of life, psychological symptoms, and hemodynamic parameters

To compare the effects of home-based and hospital-based exercise programs on exercise capacity, quality of life, psychological symptoms, and hemodynamic parameters in heart failure (HF) patients.

Seventy-four patients were randomized into either a hospital-based exercise (Group 1) or a home-based exercise (Group 2) group. Prior to and after the 8-week rehabilitation program, the two groups were compared with respect to their functional capacity [maximal oxygen uptake (pVO₂) and 6-min walk test (6MWT)], quality of life (Medical Outcomes Study and the 36-item Short Form Survey, SF-36), psychological symptoms [Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory], and hemodynamic parameters [(left ventricular diastolic diameter in diastole, left ventricular diameter in systole, Mitral Early diastolic peak flow velocity (E)/late diastolic peak flow velocity (A), Mitral E/Mitral early peak velocity (E _m), Tei index, right ventricular systolic peak velocity (S _m), tricuspid annular plane systolic excursion, systolic pulmonary arterial pressure (SPAP), and left and right ventricular ejection fraction (LVEF and RVEF)].

After the exercise programs, significant improvement was observed in pVO₂, 6MWT and subscales of physical function, general health, and vitality of SF 36, as well as BDI and LVEF in both groups (P < 0.05). A comparison of the two exercise groups revealed no significant differences between them regarding the analyzed variables (P > 0.05).

Both the hospital-based and home-based exercise groups improved significantly in functional capacity, quality of life, depression symptoms, and LVEF. Based on these results, we believe that physicians can recommend home-based exercise under strict supervision for stable HF patients. However, additional research should be conducted in this area.